Qlaira (estradiol valerate + dienogest)

Conclusion

Qlaira is a new oral contraceptive, which contains natural estrogen (estradiol valerate) combined with the gestagen dienogest. The contraceptive effect and the rate and frequency of side effects are at the same level as other oral contraceptives.

It is not documented whether natural estrogen has positive differences compared to normal oral contraceptives, which contains synthetic ethinyl estradiol. On the contrary is it previously shown that estradiol valerate results in a higher frequency of bleeding problems when it is given as continuous dose. The sequence principle in Qlaira is to minimize the bleeding problems, which is seen in continuous treatment. In the only comparative study there was found significant differences in withdrawal bleedings in advantage to the active comparator – a mono-phase tablet containing 20 μg ethinyl estradiol and 100 μg levonorgestrel.

The price of Qlaira is significantly higher than the cheapest and just as good alternative. It is hard to see the advantages for the higher price. Even the directions in, how a forgotten pill should be tackled is very difficult, because it depends on in which part of the cycle the pill was forgotten. IRF states, that Qlaira npt should be used in routine.